NPI | 1679990790 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: TX R3437) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX R3437) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-03-26 |
Last Update Date | 2022-09-13 |