| NPI | 1972762847 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DC MD037372) | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 36123735) | 
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 101252475) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D74494) | |
| Enumeration Date | 2008-06-05 | 
| Last Update Date | 2021-06-27 |