| NPI | 1225081573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME78410) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA05464300) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-06-07 |