| NPI | 1659345726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA G156131) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G156131) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 195645) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME120270) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-04-11 |