| NPI | 1538377502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 063744) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AL MD.28609) |
| 208000000X Pediatrics (Licence: TX P3088) | |
| 208000000X Pediatrics (Licence: GA 63744) | |
| 208000000X Pediatrics (Licence: AL MD.28609) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2021-01-25 |