NPI | 1447549944 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 82666) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35131514) |
2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35131514) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-04-05 |
Last Update Date | 2021-01-22 |