| NPI | 1861577512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO 41894) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 41894) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2019-02-25 |