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 |