| NPI | 1467433342 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NH 12135) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 223207) |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2012-11-20 |