| NPI | 1275831562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA C174470) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 239762) |
| 208000000X Pediatrics (Licence: CA C174470) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C174470) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD426797) | |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2024-04-11 |