| NPI | 1487782223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME140720) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AL MD27085) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2019-09-18 |