| NPI | 1801868336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery Pediatric Surgery (Licence: WI 56065) |
| Additional Taxonomies | 207RA0002X Internal Medicine Adult Congenital Heart Disease (Licence: WI 56065) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: WI 56065) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2021-01-05 |