| NPI | 1760687974 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX T2626) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX T2626) |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2024-04-05 |