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 |