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 |