| NPI | 1700203148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: TN 57676) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 57676) |
| 208000000X Pediatrics (Licence: KY 49742) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2022-03-23 |