| NPI | 1740290345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 27732) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 27732) |
| 208000000X Pediatrics (Licence: SC 6036) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 6036) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-03-05 |