| NPI | 1316000193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 0090-003375T) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 0090-003375T) |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2012-06-05 |