| NPI | 1043482698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301100922) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301100922) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NY 258619) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2021-06-14 |