| NPI | 1720290513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301101782) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: MI 4301101782) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: MN 54540) | |
| 208000000X Pediatrics (Licence: OH 35.089365) | |
| 207R00000X Internal Medicine (Licence: MI 4301101782) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2023-02-02 |