NPI | 1124110903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE C10005965) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD070561L) |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ MA07095300) | |
Enumeration Date | 2006-09-29 |
Last Update Date | 2011-12-14 |