| NPI | 1811514771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301508913) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: LA 323173) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2023-07-07 |