| NPI | 1831501014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX R2358) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT205878) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2017-07-01 |