| NPI | 1053637181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2015-00448) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD041473) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2024-04-24 |