NPI | 1548992407 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OK 9010) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL UO8782) |
Enumeration Date | 2022-06-29 |
Last Update Date | 2025-05-27 |