| 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 |