| NPI | 1578649422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME153987) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME153987) |
| 208000000X Pediatrics (Licence: NY 247957) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 001273) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2023-05-12 |