| NPI | 1851387252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA 65747) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00040811) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2023-09-01 |