| NPI | 1326001504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WV 35771) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX L8097) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 1016584) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2025-09-22 |