| NPI | 1649200817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A94973) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A94973) |
| 208000000X Pediatrics (Licence: CA A94973) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2012-06-04 |