| NPI | 1578722997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME123202) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 247060) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 48930) | |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2016-06-09 |