NPI | 1245429091 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 51436) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO 51436) |
Enumeration Date | 2007-10-17 |
Last Update Date | 2012-09-04 |