| NPI | 1124091269 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 143309) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 029942) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2023-04-18 |