| NPI | 1992122246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: LA 325991) |
| Additional Taxonomies | 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: GA 84949) |
| 2080P0204X Pediatrics Pediatric Emergency Medicine (Licence: TX R2107) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2023-07-07 |