| NPI | 1790769586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AR E6105) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 16151) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2009-10-08 |