| NPI | 1023155074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2018-0213) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2012-00227) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 002507) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-05-31 |