| NPI | 1386672970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 12199) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME0057599) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME57599) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2022-12-08 |