| NPI | 1235227208 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME 0070741)  | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME70741)  | 
| Enumeration Date | 2006-10-11 | 
| Last Update Date | 2022-06-09 |