| NPI | 1831151604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN 53774) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX K6722) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-02-11 |