| NPI | 1205140704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A142776) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A142776) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A142776) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2021-06-28 |