| NPI | 1255659801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: OR MD177563) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A117720) |
| 2083C0008X Preventive Medicine, Clinical Informatics Specialist (Licence: OR MD177563) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2018-03-17 |