| NPI | 1184291866 |
|---|---|
| Former Name | KENNETH RUSSELL ADWAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD-24358-0) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2024-07-26 |