| NPI | 1275811168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NC 2022-02801) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MS 24372) | |
| Enumeration Date | 2011-07-27 |
| Last Update Date | 2023-03-02 |