| NPI | 1588747844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: OH 35.097438) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL28151) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: TN MD0000043708) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN MD0000043708) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-03-19 |