| NPI | 1871798249 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 66324) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 66324) |
| 208000000X Pediatrics (Licence: TX M6886) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX M6886) | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-01-25 |