| NPI | 1649447871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN MD47433) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 47433) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2022-09-19 |