| NPI | 1871769281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2014020567) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: KS 04-37307) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2014-08-11 |