| NPI | 1730319526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N1720) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N1720) |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2013-05-28 |