| NPI | 1598252843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: FL me148645) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL me148645) |
| 208D00000X General Practice (Licence: FL ME148645) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-21 |
| Last Update Date | 2024-05-23 |