| NPI | 1982732178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX P4362) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301093606) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2022-02-09 |