| NPI | 1700313996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A167423) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A167423) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4301112236) | |
| Enumeration Date | 2017-05-18 |
| Last Update Date | 2024-08-15 |