| NPI | 1386968832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: KY 45990) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: KY 45990) | |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2016-10-05 |