| NPI | 1225498165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A140474) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A140474) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2026-03-24 |