| NPI | 1831184266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN 034692) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 34692) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2012-02-15 |