| NPI | 1982615407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA MD.11803R) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 11803R) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-09-22 |