| NPI | 1053511543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME113301) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 46890) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2021-02-26 |