| NPI | 1366829566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: GA 91661) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 57798) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: TN 57798) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2023-11-20 |