| NPI | 1275711723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 275548) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 003129) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2016-05-23 |