| NPI | 1538547880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX T6631) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301107028) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 80215) | |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2022-08-19 |