| NPI | 1497118954 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 41288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 37180) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2026-06-12 |