| NPI | 1720216211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV 22312) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 31975) |
| 208000000X Pediatrics (Licence: TX Q8714) | |
| 208000000X Pediatrics (Licence: SC LL31975) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2022-08-05 |