| NPI | 1104269869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX U4162) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MD D0090270) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD457398) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE C10023890) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA1090800) | |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2024-07-25 |