| NPI | 1952557332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A115159) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301092195) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 58949) | |
| Enumeration Date | 2008-08-17 |
| Last Update Date | 2015-06-26 |