| NPI | 1093120941 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 69618) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 135810) |
| 208000000X Pediatrics (Licence: TX T6506) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX T6506) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-12-05 |