| NPI | 1770043390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 13896242-1205) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MD D94055) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2024-04-01 |