| NPI | 1184032062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 10358523-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 59618) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2021-07-12 |