| NPI | 1932175007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN MD49439) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD046861L) |
| 208000000X Pediatrics (Licence: TN MD49439) | |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2022-03-15 |