| NPI | 1265672471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: HI 15832) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX Q4164) | |
| Enumeration Date | 2009-02-27 |
| Last Update Date | 2016-10-28 |