| NPI | 1639556251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX T0070) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T0070) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2021-09-28 |