| NPI | 1972995611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: MI 4301511350) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO R114322009) |
| Enumeration Date | 2015-03-03 |
| Last Update Date | 2024-09-30 |