| NPI | 1518036821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA C173773) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C173773) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX L9757) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-07-19 |