| NPI | 1508948621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 244196) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DE C1-0006697) |
| 208000000X Pediatrics (Licence: NY 244196) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2009-05-27 |