| NPI | 1821523002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A169422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A169422) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2024-04-28 |