| NPI | 1316262710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MT MED-PHYS-LIC-113820) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 271030-1) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.134313) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 57.025498) | |
| 208000000X Pediatrics (Licence: WA 60156855) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2025-04-09 |