| NPI | 1346627544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MS 29776) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 52251) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2022-08-25 |