| NPI | 1881855930 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 56639) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 70778) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35.126320) | |
| 208000000X Pediatrics (Licence: AZ 70778) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2018-03-17 |