| NPI | 1912965237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NM 96345) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ID M11905) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2014-02-06 |