| NPI | 1376069039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 282403) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 244851) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2020-10-17 |