| NPI | 1073605481 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN MD20792) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NM MD2015-0226) |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-03-25 |