| NPI | 1942596820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 55451) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 55451) |
| 208000000X Pediatrics (Licence: MN 55451) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2023-10-30 |