NPI | 1396950978 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD430635) |
Additional Taxonomies | 208000000X Pediatrics (Licence: AR E-6958) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2015-01-07 |