| 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 |