| NPI | 1003263849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: PA MD468996) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2024-09-18 |