| 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 | 2023-09-22 |