| NPI | 1477813350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX S1956) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TX pending) | |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2023-04-20 |