| NPI | 1609895994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 309978) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD421500) |
| 208000000X Pediatrics (Licence: PA MD421500) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 67727) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2023-11-02 |