| NPI | 1174936884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 292373) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036.143336) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2022-09-16 |