| NPI | 1851376883 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 35712)  | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036085819)  | 
| Enumeration Date | 2005-12-13 | 
| Last Update Date | 2022-07-21 |