| NPI | 1598025116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CA A135002) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: CA A135002) | |
| 208000000X Pediatrics (Licence: AZ 51747) | |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: AZ 51747) | |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2022-08-01 |