| NPI | 1326589672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT219736) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 272450) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CT 77093) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-03-19 |
| Last Update Date | 2024-05-28 |