| NPI | 1801806377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 31905) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 31905) |
| 208000000X Pediatrics (Licence: SC 9406) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 9406) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2014-04-25 |