| NPI | 1093847360 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME109914) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME109914) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MT MED-PHYS-LIC-21131) | |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-09-01 |