| NPI | 1609847680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 26462) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L9472) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX L9472) | |
| 207R00000X Internal Medicine (Licence: OK 26462) | |
| 208000000X Pediatrics (Licence: OK 26462) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2015-07-01 |