| NPI | 1033100912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 47333) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 47333) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2010-01-13 |