| NPI | 1871695429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME0046120) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME0046120) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2013-07-16 |