| NPI | 1205216223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: OH 35.130634) |
| Additional Taxonomies | 2080N0001X Pediatrics Neonatal-Perinatal Medicine (Licence: OH 130634) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.130634) | |
| 208000000X Pediatrics (Licence: PA MT208110) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2022-07-21 |