| NPI | 1164650644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 236319) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CT 048213) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2015-04-27 |