| 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 | 2024-12-31 |