| NPI | 1124019864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: MA 71141) |
| Additional Taxonomies | 174400000X Specialist (Licence: MA 71141) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2020-11-18 |