| NPI | 1174902548 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A149388) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 38421) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2023-12-28 |