| NPI | 1033384805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: LA 336352) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: LA 336352) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 65626) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2023-08-30 |