| NPI | 1710199161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: TX S0115) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD437231) |
| 208000000X Pediatrics (Licence: NY 268147) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 268147) | |
| Enumeration Date | 2007-05-05 |
| Last Update Date | 2021-11-16 |