| NPI | 1144612565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR.0064139) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX 583597) |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2021-09-21 |