| NPI | 1679595409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD017514E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD017514E) |
| 208000000X Pediatrics (Licence: NJ 25MA03778900) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA03778900) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2012-03-21 |