NPI | 1619322484 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: VA 0101267505) |
Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101267505) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-04-29 |
Last Update Date | 2024-07-30 |