| NPI | 1508243700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AZ FW0373720) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: IA MD-45150) | |
| Enumeration Date | 2015-04-27 |
| Last Update Date | 2021-10-23 |