| NPI | 1740450600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX S5205) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD443100) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE C1-0009795) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2022-02-16 |