| NPI | 1528420023 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX U5371) | 
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: TX U5371) | 
| 208000000X Pediatrics (Licence: MO 2020013176) | |
| 208000000X Pediatrics (Licence: IL 1528420023) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-23 | 
| Last Update Date | 2024-08-13 |