| NPI | 1750810586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA12153900) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 305673) |
| 208000000X Pediatrics (Licence: NJ 25MA12153900) | |
| 208000000X Pediatrics (Licence: PA MT213039) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 305673) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2024-05-08 |