| NPI | 1942560156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301108086) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301108086) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD464734) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2020-06-10 |