| NPI | 1144453762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SD 9595) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SD 9595) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2019-04-23 |