| NPI | 1962927731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 95401) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 95401) |
| Enumeration Date | 2017-08-13 |
| Last Update Date | 2026-07-01 |