| NPI | 1881936144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 53788) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60942196) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2024-04-24 |