| NPI | 1609229525 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: WI 85856-20) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S8070) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2025-07-18 |