| NPI | 1780909275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AZ 55804) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 55804) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2018-08-29 |