| NPI | 1750841359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080I0007X Pediatrics, Clinical & Laboratory Immunology (Licence: GA 93367) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA 93367) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2022-12-28 |