| NPI | 1174910830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: TN 58648) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 0000058648) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2025-07-28 |