| NPI | 1063152551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.153752) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-07-09 |