| NPI | 1396795258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL OS 10209) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: PA OS010552L) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: NJ MB 70340) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2011-11-21 |