| NPI | 1730188806 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 12087R) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 12087R) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 12087R) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA MD.12087R) | |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2022-03-29 |