| NPI | 1982800645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 58258) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 107551) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-21 |