| NPI | 1912226721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: UT 12048930-1205) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX Q7852) |
| Enumeration Date | 2010-05-19 |
| Last Update Date | 2021-11-12 |