| NPI | 1356402218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX J7251) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX J7251) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2007-11-29 |