| NPI | 1528432325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX 45317) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: TX 45317) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |