NPI | 1790988962 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MO 2013013663) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR.0066722) |
Enumeration Date | 2007-06-06 |
Last Update Date | 2021-06-04 |