| NPI | 1639322407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N5041) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10023326) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX N5041) | |
| Enumeration Date | 2008-10-24 |
| Last Update Date | 2022-01-11 |