| NPI | 1205077138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301109363) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A119895) |
| 208000000X Pediatrics (Licence: MI 4301109363) | |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2016-08-02 |