| NPI | 1689930174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MA 262765) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 262765) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2020-10-02 |