| NPI | 1346735180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: GA 99136) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 99136) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL TRN26986) | |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2024-09-07 |