| NPI | 1932392347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MN 68324) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 68324) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA 42220) | |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2021-09-22 |