| NPI | 1336117043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MA 160252) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 160252) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2010-03-30 |