| NPI | 1558588277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL ME113413) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.091513) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2020-04-08 |