| NPI | 1538503412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TN 54450) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 54450) |
| 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: PA MD466866) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2020-12-29 |