| NPI | 1164467288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0040310) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D0040310) |
| 174400000X Specialist (Licence: VA 0101246900) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101246900) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2012-12-08 |