| 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 |