| NPI | 1427319789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CT 63689) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: DE C2-0011594) | |
| 208000000X Pediatrics (Licence: DE C2-0011594) | |
| 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NH 39389) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2026-07-08 |