| NPI | 1891731907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MN 17125) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 17125) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 17125) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2016-03-18 |