| NPI | 1629496781 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: CA A149068) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2022-08-04 |