| NPI | 1972787760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 064569) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 002845) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2021-01-22 |