| NPI | 1134562614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 283904) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 283904) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2019-04-09 |