| NPI | 1932362530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WA 60926635) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 260056) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 2600561) | |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2024-05-16 |