| NPI | 1508975749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD431438) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD431438) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 174952-1205) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-04-16 |