| NPI | 1174967988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 309382-01) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD457201) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2022-01-17 |