| NPI | 1952392888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MA 159958) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 159958) |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2009-12-10 |