| NPI | 1871535088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D63602) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101249756) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D63602) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101249756) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2011-07-01 |