| NPI | 1386134641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WA OP61530316) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2021012583) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-12 |
| Last Update Date | 2024-07-24 |