| NPI | 1669710018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN 63094) |
| Additional Taxonomies | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TN 63094) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2021-10-11 |