| NPI | 1548450216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX M0300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M0300) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2018-09-11 |