NPI | 1164569448 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: CO 46572) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL-141) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2022-02-22 |