| NPI | 1881675221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OR MD19759) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD00033786) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2022-07-18 |