| NPI | 1134474380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N7062) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX n7062) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2024-02-20 |