| NPI | 1912338948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 49525) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY TP262) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DC MD041603) | |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2017-12-19 |