| NPI | 1992156319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics Pediatric Cardiology (Licence: FL ME153322) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 23393) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT219475) | |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2022-04-04 |