| NPI | 1023271749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD442029) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA11542100) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2025-04-09 |