| NPI | 1801214044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: RI MD21369) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 269986) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2026-05-20 |