| NPI | 1265528574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA MD.011862) |
| Additional Taxonomies | 174400000X Specialist (Licence: LA 011862) |
| 174400000X Specialist (Licence: MS 11240) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-09-09 |