| NPI | 1821559949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125.073906) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2022-06-19 |