| NPI | 1396108494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX S1142) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S1142) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2023-06-13 |