| NPI | 1942264650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME125623) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 154642) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: MA 154642) | |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL ME125623) | |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MA 154642) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2021-04-14 |