| NPI | 1932442217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2024-00650) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR MD176915) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OR MD176915) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2024-05-14 |