| NPI | 1023040326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 2567541) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 044231) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-05-22 |