| NPI | 1679816748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: DC MD210002121) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DC MD210002121) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2022-07-05 |