| NPI | 1740786508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.149933) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: OH 35.149933) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2025-05-19 |