| NPI | 1366885402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 54740) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 54740) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 54740) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2022-03-15 |