NPI | 1013265776 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: DE C1-0023876) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA10956600) |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 251206) | |
Enumeration Date | 2012-08-28 |
Last Update Date | 2021-07-14 |