| NPI | 1730507997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0001X Internal Medicine, Clinical Cardiac Electrophysiology (Licence: NE 33429) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NE 33429) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: NE 33429) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2025-11-18 |