| NPI | 1912060799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine Interventional Cardiology (Licence: SC 18163) |
| Additional Taxonomies | 207RA0002X Internal Medicine Adult Congenital Heart Disease (Licence: SC 18163) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL ME115052) | |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: NC T01728) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2022-02-18 |