| NPI | 1376690172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 2010-00604) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 45327) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NC 2010-00604) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2010-05-11 |