| NPI | 1548825086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MI 4301513863) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301513863) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2025-07-15 |