| NPI | 1770707234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: TN 42605) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TN 390200000X) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-10-15 |