| NPI | 1720014509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX F5263) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TX F5263) |
| 208000000X Pediatrics (Licence: TX F5263) | |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2018-09-18 |