| NPI | 1477908218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME175696) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 59453) |
| 208000000X Pediatrics (Licence: FL ME175696) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2025-07-25 |