| NPI | 1679786594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX U8040) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: TX U8040) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME160949) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2025-12-29 |