| NPI | 1740806884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MB13075900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL83247) |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2026-07-01 |