| NPI | 1134814114 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX W5917) |
| Additional Taxonomies | 207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology (Licence: TX W4092) |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2026-06-01 |