| NPI | 1902868094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: AZ 8958) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 8958) |
| Enumeration Date | 2006-04-04 |
| Last Update Date | 2009-09-16 |