| NPI | 1962021105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080T0004X Pediatrics, Pediatric Transplant Hepatology (Licence: PA MT236296) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 208000000X Pediatrics (Licence: OH 57.249837) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2026-06-08 |