NPI | 1982821799 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: FL ME113107) |
Additional Taxonomies | 2080P0202X Pediatrics, Pediatric Cardiology (Licence: CO DR47006) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2007-04-20 |
Last Update Date | 2023-05-11 |