| NPI | 1689893919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AR E-5560) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AR E-5560) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P6393) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX P6393) | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-01-08 |