| NPI | 1477713733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 64307) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NY 236701) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2021-01-25 |