| NPI | 1518261171 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101275867)  | 
| Additional Taxonomies | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: TN 55743)  | 
| 208000000X Pediatrics (Licence: TX 550237)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 55743)  | |
| Enumeration Date | 2010-12-22 | 
| Last Update Date | 2022-11-11 |