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 |