| NPI | 1871783555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: IL 036-130145) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35-097596) |
| 208000000X Pediatrics (Licence: IL 036-130145) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2021-10-19 |