| NPI | 1629417555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX S6969) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 6RTP00173) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2021-04-13 |