| NPI | 1679781504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 64531) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R-7293) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2010-06-23 |