| NPI | 1447592605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 12359250-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML60368390) |
| 208000000X Pediatrics (Licence: UT 12359250-1205) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MT210303) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2022-01-11 |