| NPI | 1487117479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA13148200) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD477764) |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2026-06-11 |