| NPI | 1629118468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C39988) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C39988) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-12-11 |