| NPI | 1760822738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: AZ 77319) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NV 18948) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL 161059) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: FL 18360) | |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2025-06-09 |