NPI | 1770110710 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NM MD2022-1475) |
Additional Taxonomies | 208000000X Pediatrics (Licence: ID M-17535) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-26 |
Last Update Date | 2024-07-05 |