| NPI | 1871836999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 63310) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD50047) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD50047) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2025-06-23 |