| NPI | 1568881027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IA MD-44290) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 65207-20) |
| 208000000X Pediatrics (Licence: IA MD-44290) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2022-07-21 |