| NPI | 1326023607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME104590) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 27371) |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2018-06-15 |