| NPI | 1902888613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD-33317) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-33317) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 33317) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2021-01-12 |