NPI | 1437438207 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX R6609) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 55360) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-08-11 |
Last Update Date | 2021-04-06 |