| NPI | 1063471316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX W3825) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.091565) |
| 208000000X Pediatrics (Licence: TX W3825) | |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2026-03-09 |