| NPI | 1114941416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: AZ 35247) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 35247) |
| 208000000X Pediatrics (Licence: IA 37244) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-02-01 |