| NPI | 1790809168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: AZ 42040) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301085419) |
| 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301085419) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301085419) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2010-11-12 |