| NPI | 1568577633 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: NC 2006-01306) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2006-01306) | 
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2006-01306) | |
| Enumeration Date | 2006-08-20 | 
| Last Update Date | 2024-07-15 |