| NPI | 1881741676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2004-01635) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN MD0000044254) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2009-03-23 |