| NPI | 1972827772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: OH 35.130573) |
| Additional Taxonomies | 2080P0202X Pediatrics Pediatric Cardiology (Licence: KY 50500) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2017-09-07 |