| NPI | 1427223346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 57012940) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD449353) |
| 208000000X Pediatrics (Licence: OH 57012940) | |
| 208000000X Pediatrics (Licence: MN 104900) | |
| 208000000X Pediatrics (Licence: MN 53481) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2017-01-19 |