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 |