| NPI | 1659354884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 037193) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 251236) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2023-07-06 |