| NPI | 1598748295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD055284L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD055284L) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 037687) | |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2013-04-16 |