NPI | 1902148919 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.144038) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TN 62280) |
208000000X Pediatrics (Licence: MI EMC0002365) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2013-03-18 |
Last Update Date | 2023-11-03 |