| NPI | 1073043808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 274381) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: MA 274381) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NH 24769) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-10-23 |