| 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) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 57540) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ND 13518) | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 58258) | |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2026-07-21 |