| NPI | 1821319310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NE 26347) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NE 26347) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2025-03-14 |