| NPI | 1851577399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: CT 46525) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 262722-1) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: NY 262722-1) | |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2021-11-19 |