| NPI | 1275895559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 25641) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 17368) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2018-08-06 |