| NPI | 1952570418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: AK 147297) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 208000000X) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2024-01-12 |