| NPI | 1417344631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: CA A163064) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 18272) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-26 |
| Last Update Date | 2022-08-05 |