| NPI | 1639138316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ ma58241) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY NY164387) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2017-02-23 |