| NPI | 1073625059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NH 9173) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VT 042-0008944) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-04-16 |