NPI | 1275876559 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2016-0491) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM 1275876559) |
Enumeration Date | 2013-04-04 |
Last Update Date | 2017-02-15 |