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 |