| NPI | 1417004136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N6842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N6842) |
| 208000000X Pediatrics (Licence: TN MD50296) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX N6842) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TN MD50296) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2022-01-04 |