NPI | 1972914406 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: ID M-13708) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TN 55030) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-05-19 |
Last Update Date | 2018-03-17 |