| NPI | 1255628244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: HI MD-19393) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.060486) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: HI MD-19393) | |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2018-08-16 |