| NPI | 1720050313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: RI MD8005) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 75512) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2014-05-30 |