| NPI | 1790986339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2007-00680) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2007-00680) |
| 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: NC 2007-00680) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2023-12-18 |