| NPI | 1952516429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: MO 2015010977) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M7810) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 56007) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 56007) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2015010977) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 0438091) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: KS 0438091) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2015-10-21 |