| NPI | 1770973075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME138415) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME138415) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2020-08-18 |