| NPI | 1568463537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA G8095) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 213923) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2018-08-29 |