| NPI | 1538398169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME171905) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301094385) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301094385) | |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2025-01-28 |