| NPI | 1144237645 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ MA54586)  | 
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 198709)  | 
| Enumeration Date | 2006-08-01 | 
| Last Update Date | 2007-07-08 |