| 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 |