| NPI | 1376801738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD455288) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DC MD046411) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2021-01-22 |