| NPI | 1184041329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: PA MT212422) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX R1560) |
| 208000000X Pediatrics (Licence: PA MD460819) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2022-07-21 |