| NPI | 1942487863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME115878) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301089534) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2013-07-26 |