NPI | 1538572516 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX T1173) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.133155) |
Enumeration Date | 2014-06-06 |
Last Update Date | 2021-05-04 |