| NPI | 1689133688 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2022-00960) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2022-00960) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 2022-00960) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2023-05-04 |