| NPI | 1568686277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: IL 036-129846) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301083662) |
| 207R00000X Internal Medicine (Licence: MI 4301083662) | |
| 208000000X Pediatrics (Licence: MI 4301083662) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2022-11-11 |