| NPI | 1154539385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 063459) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL MD.28540) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207P00000X Emergency Medicine (Licence: AL MD.28540) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2021-01-22 |