| NPI | 1114241916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA OS020467) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 02004364A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2022-08-26 |