| NPI | 1497711071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 33804) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-21304) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2015-09-22 |