| NPI | 1790801371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NJ 25MA08663900) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD436538) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2016-11-04 |