| NPI | 1699209965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: FL ME144468) |
| Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CO DR.0077747) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: CO DR.0077747) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2026-08-06 |