NPI | 1194475624 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0103173) |
Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD600003635) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-03-27 |
Last Update Date | 2025-06-11 |