| NPI | 1508109364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME145837) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME145837) |
| 208000000X Pediatrics (Licence: NC 321914) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME145837) | |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NC 321914) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NC 321914) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2024-06-12 |