| NPI | 1639126006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME142390) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME142390) |
| 208000000X Pediatrics (Licence: FL ME142390) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2025-09-07 |