| NPI | 1831348960 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 270302) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OK 26601) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2021-05-04 |