| NPI | 1740819010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 14206717-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ID M-17294) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2025-03-07 |