| NPI | 1881721165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301080539) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301080539) |
| 208000000X Pediatrics (Licence: MI 4301080539) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-03-02 |