| NPI | 1053545376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A107618) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A107618) |
| 208000000X Pediatrics (Licence: SC 33807) | |
| Enumeration Date | 2009-05-14 |
| Last Update Date | 2015-07-16 |