| NPI | 1497136063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2024-00365) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: NC 202400365) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2024-00365) | |
| 208000000X Pediatrics (Licence: NC 2024-00365) | |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2026-03-02 |