| NPI | 1780810135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2017015469) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: KS 05-39557) |
| 208600000X Surgery (Licence: KS 94-07138) | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: KS 0539557) | |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2022-07-21 |