| NPI | 1366732992 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 252185) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME109441) |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2018-08-14 |