NPI | 1033746482 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: MO 2024025376) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.249203) |
208000000X Pediatrics (Licence: OH 57.249203) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-25 |
Last Update Date | 2024-07-30 |