NPI | 1851735997 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 12326293-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX Q8575) |
Enumeration Date | 2013-04-19 |
Last Update Date | 2021-11-08 |