NPI | 1881679157 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 079523) |
Additional Taxonomies | 208000000X Pediatrics (Licence: NY 079523) |
Enumeration Date | 2005-12-09 |
Last Update Date | 2013-03-26 |