| NPI | 1730480336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 224179-1) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 224179-1) |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2013-02-14 |