| NPI | 1285612887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101023633) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D0015898) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2007-10-24 |