| NPI | 1912950338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ID M-8136) |
| Additional Taxonomies | 174400000X Specialist (Licence: ID M-8136) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2025-02-04 |