| NPI | 1952750051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: LA 332167) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME140342) |
| 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: TX U7855) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2024-04-05 |