| NPI | 1871544429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD010011908) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ID M-5143) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MT 7800) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2021-05-19 |