| NPI | 1689068173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VT 042.0017516) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: NY 327037) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 327037) | |
| 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: VT 042.0017516) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2024-08-14 |