| NPI | 1184912784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OR MD210288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD210288) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OR MD210288) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301117244) | |
| 208000000X Pediatrics (Licence: MI 4301117244) | |
| Enumeration Date | 2011-07-16 |
| Last Update Date | 2022-07-12 |