| NPI | 1235127119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD042598E) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA05237400) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-04-16 |