| NPI | 1235153743 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD038928E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD038928E) |
| 208000000X Pediatrics (Licence: NJ 25MA06250500) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA06250500) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2014-10-27 |