| NPI | 1770816951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX Q1847) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125056256) |
| Enumeration Date | 2009-09-06 |
| Last Update Date | 2017-04-16 |