| NPI | 1720180698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NH 8388) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VT 42-0008233) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 55659) | |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2011-07-22 |