| NPI | 1417959834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0120X Surgery, Pediatric Surgery (Licence: NY 218128-1) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 218128-1) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2025-09-11 |