| NPI | 1710481965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MT224897) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: PA MD478202) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2022-06-21 |