| NPI | 1881672632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 33140) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 33140) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 28845) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2020-08-19 |