| NPI | 1649624420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: SC 88103) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 59156) |
| 208M00000X Hospitalist (Licence: TN 59156) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2022-08-16 |