| NPI | 1710143383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IA MD-53980) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: IA MD-53980) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 280364) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 280364-1) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2025-01-09 |