| NPI | 1548605140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 283684) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01072510A) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2023-03-16 |