| NPI | 1447205224 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 20358) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WY 3421-A) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NE 21022) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2007-07-08 |