| NPI | 1972096378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: UT 13896234-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL52598) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2024-03-29 |