NPI | 1518461516 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A19272) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PA OT018515) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-23 |
Last Update Date | 2024-02-07 |