| NPI | 1316259468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101020021) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101020021) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2010-07-06 |