NPI | 1902433063 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA A184791) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA A184791) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-26 |
Last Update Date | 2024-06-22 |