| NPI | 1952922379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: HI MD22182) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI md-22182-0) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2024-02-12 |