NPI | 1659543080 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: TX N0003) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP50023713) |
Enumeration Date | 2008-03-26 |
Last Update Date | 2008-12-04 |