| NPI | 1720518921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 77385) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX V0217) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2026-08-10 |