| NPI | 1205928058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: DE C10006599) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ MA07455400) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD419538) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2011-12-23 |