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 |