NPI | 1649561614 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: CT 53423) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 53423) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-04-26 |
Last Update Date | 2023-09-12 |