| NPI | 1740713684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME177300) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2026-02-18 |