| NPI | 1942654843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 59258) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: TN 59258) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2024-05-28 |