NPI | 1497332514 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA12218700) |
Enumeration Date | 2021-03-25 |
Last Update Date | 2024-08-01 |