| NPI | 1215917265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: MA 228276) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MA 214221) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2019-06-18 |