| NPI | 1114243144 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NM MD2016-0488) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: NM MD2016-0488) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2016-07-26 |