| NPI | 1093700783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 33308) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NV 9709) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2008-06-05 |