| NPI | 1447549944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: GA 82666) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: OH 35131514) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35131514) | |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2026-04-23 |