| NPI | 1689863425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P7066) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD-43568) |
| 208000000X Pediatrics (Licence: IA MD-43568) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2018-11-05 |