| NPI | 1477640555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 118259) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 118259) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2007-07-08 |