| NPI | 1821408568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MD D90361) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-05-03 |
| Last Update Date | 2020-11-04 |