| NPI | 1952796260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CA A185844) |
| Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: MI 4301505804) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2023-05-19 |