NPI | 1487074712 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TN 56186) |
Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TN 56186) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-25 |
Last Update Date | 2018-06-27 |