| NPI | 1871729699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: UT 11753222-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102202699) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0102202699) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2024-01-22 |