| NPI | 1518087790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 237999) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 237999) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2022-05-27 |