| NPI | 1952668311 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: AL MD.33016) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 308672) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: LA 308672) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2021-12-20 |