| NPI | 1861678732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NV 13533) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 002162) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2010-10-30 |