| NPI | 1003493685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: OH 35.153002) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME169483) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-03-28 |
| Last Update Date | 2025-07-09 |