| NPI | 1467610816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VA 0101254028) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 0101254028) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: IN 01068068A) | |
| Enumeration Date | 2008-05-31 |
| Last Update Date | 2013-06-18 |