NPI | 1699036558 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: IL 036146666) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO DR.0055597) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2012-06-06 |
Last Update Date | 2019-11-14 |