| NPI | 1629606926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 13891537-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY P100915) |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2024-04-03 |