| NPI | 1982820338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2012032420) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012032420) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2015-07-31 |