| NPI | 1821384264 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 62462) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NV 17105) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2025-05-09 |