| NPI | 1790042125 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: DE C1-0011792) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE C1-0011792) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE c7-0005125) | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2018-08-16 |