| NPI | 1376705699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MS 23935) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN MD47801) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2022-07-21 |