| NPI | 1134431760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 51522) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301096862) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101253528) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2023-11-16 |