| NPI | 1114115631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL ME102741) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: CA A96519) |
| 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: FL ME102741) | |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2013-08-05 |