| NPI | 1699905588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME123742) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME123742) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2025-10-20 |