| NPI | 1447435672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: ME MD28177) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 254076) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX P7026) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2024-08-07 |