| NPI | 1881893808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: LA 303412) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX N5944) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2022-11-01 |