| NPI | 1134428899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: ME MD24051) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: SD 10514) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: RI LP03247) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2020-10-22 |