| NPI | 1083815914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR.0051896) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A103511) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2013-01-17 |