| NPI | 1124283296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: SD 9522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2008018593) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 106264) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 55807) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2015-07-23 |