| NPI | 1619920469 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: TN 57888)  | 
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: OH 35096072)  | 
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MS 26120)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 60245)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 33376)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.096072)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 57888)  | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 26120)  | |
| Enumeration Date | 2006-05-19 | 
| Last Update Date | 2018-08-29 |