| NPI | 1134296296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME119937) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 33996) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2018-02-12 |