| NPI | 1548228638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX G6022) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX G6022) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2007-07-08 |