| NPI | 1912286493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A114502) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD451716) |
| 208000000X Pediatrics (Licence: CA A114502) | |
| Enumeration Date | 2011-08-15 |
| Last Update Date | 2018-03-17 |