| NPI | 1184870685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0102202353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102202353) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD H68910) | |
| Enumeration Date | 2008-08-15 |
| Last Update Date | 2022-04-26 |