| NPI | 1972957884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 68038) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 082702) |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2023-07-12 |