| NPI | 1659725257 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL ME175183) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-11-12 |