| NPI | 1407843113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P7756) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KS 05-30319) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA 20A11034) | |
| 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: KS 530319) | |
| 207P00000X Emergency Medicine (Licence: TX P7756) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2023-11-27 |