| NPI | 1861474561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA G76012) |
| Additional Taxonomies | 207RA0002X Internal Medicine, Adult Congenital Heart Disease (Licence: CA G76012) |
| 208000000X Pediatrics (Licence: CA G76012) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2024-04-12 |