| NPI | 1437475225 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: PA MD4653338) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: GA 69599) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MA 258803) | |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2023-06-01 |