| NPI | 1316524267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 13896264-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 71909) |
| 208000000X Pediatrics (Licence: MN 31602) | |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2024-03-28 |