| NPI | 1871955740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2023027650) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-48025) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2026-02-24 |