| NPI | 1245206804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AL 28151) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 15036R) |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2014-12-04 |