| NPI | 1871818898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 254664) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME131603) |
| Enumeration Date | 2010-04-01 |
| Last Update Date | 2022-10-21 |