| NPI | 1043552870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 62862) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ 62862) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 62862) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: AZ 62862) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2023-05-05 |