| NPI | 1932436508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 46084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 46084) |
| 208000000X Pediatrics (Licence: NY 255254) | |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2022-04-15 |