| NPI | 1588628895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G24862) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA G24862) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2007-07-08 |