| NPI | 1639258106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME146696) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 341951-1205) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2022-01-11 |