| NPI | 1487955894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: FL ME120005) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME120005) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: RI MD13590) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: RI MD13590) | |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2018-04-17 |