| NPI | 1518191071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX P6018) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10038096) |
| 208000000X Pediatrics (Licence: PA MD437938) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2013-05-14 |