| NPI | 1659053684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: OH 52.255717) |
| Enumeration Date | 2023-08-01 |
| Last Update Date | 2025-05-15 |