| NPI | 1407119720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD454745) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT201284) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2018-06-14 |