| NPI | 1154555829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A135658) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A135658) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2024-04-11 |