NPI | 1598728396 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25ma06221900) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 189637) |
Enumeration Date | 2006-04-11 |
Last Update Date | 2017-02-14 |