| NPI | 1902015324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: VA 0101231757) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101231757) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2014-04-01 |