| NPI | 1063532828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN MD46935) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SD 8753) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TN 46936) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2019-03-29 |