| NPI | 1255421434 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101241673)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101241673)  | 
| 207R00000X Internal Medicine (Licence: SC 23152)  | |
| 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: VA 0101241673)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SC 23152)  | |
| Enumeration Date | 2006-10-16 | 
| Last Update Date | 2021-04-13 |