| NPI | 1366065021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 13289379-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL84199) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2023-03-07 |