| NPI | 1528296142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MB09737300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MB08737300) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2024-05-02 |