NPI | 1710383187 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA 20A14267) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 20A14267) |
2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: NV DO2907) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-11-13 |
Last Update Date | 2023-01-31 |