| NPI | 1467885889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA C28397) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C28397) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2022-09-22 |