| NPI | 1932634102 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 81643-20)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 81643-20)  | 
| Enumeration Date | 2017-04-26 | 
| Last Update Date | 2025-04-09 |