| NPI | 1841532140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 12062385-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D81125) |
| Enumeration Date | 2013-03-25 |
| Last Update Date | 2021-10-28 |