| NPI | 1811376569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U5765) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 10994068-1205) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2025-10-08 |