| NPI | 1023271749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 258267) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT192836) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 258267) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2020-10-09 |