| NPI | 1306239918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CA C186470) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01079643A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-07 |
| Last Update Date | 2023-07-20 |