| NPI | 1548766835 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080S0012X Pediatrics, Sleep Medicine (Licence: ID M-17623)  | 
| Additional Taxonomies | 2080S0012X Pediatrics, Sleep Medicine (Licence: WI 77233)  | 
| 2080S0012X Pediatrics, Sleep Medicine (Licence: WA MD61145727)  | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-04 | 
| Last Update Date | 2024-05-19 |