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 |