NPI | 1336414309 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A120134) |
Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: CA A120134) |
208000000X Pediatrics (Licence: CA A120134) | |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 63794) | |
Enumeration Date | 2012-03-09 |
Last Update Date | 2021-09-03 |