NPI | 1841634177 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: LA 320536) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A134391) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-04-17 |
Last Update Date | 2019-08-23 |