NPI | 1730332495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.143351) |
Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: OH 35.143351) |
208000000X Pediatrics (Licence: CA A126681) | |
208000000X Pediatrics (Licence: PA MD429326) | |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A126681) | |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD429326) | |
Enumeration Date | 2008-10-28 |
Last Update Date | 2021-11-07 |