| NPI | 1467598458 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101249560) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD P19047) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35090462) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2021-01-19 |