| NPI | 1073769048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME120031) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 51994) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2014-09-19 |