| NPI | 1447283775 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A83169) | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NM MD2023-1255) | 
| Enumeration Date | 2006-07-09 | 
| Last Update Date | 2024-07-05 |