| NPI | 1790941367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: KY 48279) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT192388) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: KY 48279) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2021-06-13 |