| NPI | 1811996184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 019862) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 019862) |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 019862) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2023-04-25 |