| NPI | 1417913179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 28238) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 48235) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A106455) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2015-05-12 |