| NPI | 1194757948 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 26707) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 49579) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-09-20 |