| NPI | 1831612993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: FL FC9162607) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S4740) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10059145) | |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2022-09-06 |