NPI | 1326169061 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MN 49746) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ND 12259) |
390200000X Student in an Organized Health Care Education/Training Program | |
208000000X Pediatrics (Licence: MN 49746) | |
Enumeration Date | 2007-04-02 |
Last Update Date | 2021-11-18 |