| NPI | 1336191592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX TEMP) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA MD.14384R) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2010-06-08 |