| NPI | 1750360970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME117336) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 47136) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AR E-5289) | |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2013-11-04 |