| NPI | 1043482672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P0268) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX P0268) |
| 208000000X Pediatrics (Licence: MI 4301100007) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301100007) | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2021-12-03 |