| NPI | 1558350504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 35906) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 13616) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2017-01-09 |