NPI | 1386262525 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: AL MD.50674) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 43510466934) |
390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351046934) | |
Enumeration Date | 2020-07-13 |
Last Update Date | 2025-06-10 |