| NPI | 1306101415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301107188) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NM MD2018-0069) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX R8513) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2022-08-04 |