| NPI | 1285013623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 310255) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 310255) |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2023-07-07 |