| NPI | 1457526055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: PA MD441748) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MI 4301088163) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2012-02-14 |