| NPI | 1154315893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 26825) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 26825) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2019-03-08 |