| 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 |