NPI | 1841533072 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX R2657) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A124770) |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT205572) | |
Enumeration Date | 2013-04-06 |
Last Update Date | 2019-09-12 |