| NPI | 1568506186 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 35588) | 
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: AZ 35588) | 
| 208000000X Pediatrics (Licence: AZ 35588) | |
| 208000000X Pediatrics (Licence: MP 0418) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101245020) | |
| Enumeration Date | 2007-02-16 | 
| Last Update Date | 2023-09-12 |