| NPI | 1174582845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A87656) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A87656) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA 39660) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2014-07-16 |