| NPI | 1619085651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2012015564) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KS 04-35680) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 20465) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2012-07-12 |