| NPI | 1306160593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 49964) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX BP10036438) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 49964) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 20A10024) | |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2024-10-02 |