| NPI | 1376712653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: CO 0062842) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 43700) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 336-074702) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO 0062842) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2024-03-14 |