| NPI | 1639114077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 34779) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA 34779) |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2007-07-13 |