| NPI | 1184695132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 227737) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 227737) |
| Enumeration Date | 2006-01-29 |
| Last Update Date | 2008-06-18 |