| NPI | 1679885727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX Q8353) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT197030) |
| 208000000X Pediatrics (Licence: PA MD447577) | |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2018-11-27 |