NPI | 1275854713 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NE 28891) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011033546) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2010017403) | |
Enumeration Date | 2010-06-18 |
Last Update Date | 2019-09-20 |