| NPI | 1225491392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: ND 18666) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: 63799) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2022-08-30 |