| NPI | 1558481127 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: HI 14185) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI 14185) | 
| Enumeration Date | 2007-03-29 | 
| Last Update Date | 2024-06-07 |