| NPI | 1538195805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MS 15292) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: LA MD.12196R) |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2015-09-09 |