| NPI | 1255301974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 22611) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ME 016355) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ME MD16355) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-11-23 |