| NPI | 1083666127 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA MD00039312) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ID M-8823) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2015-10-01 |