| NPI | 1912296757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2014011778) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2014011778) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2021-01-18 |