| NPI | 1174815005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TX R7258) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CA A123480) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2021-12-02 |