NPI | 1497118954 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: AL 37180) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OK 41288) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-01 |
Last Update Date | 2023-06-20 |