| NPI | 1942694591 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A155668) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A155668) | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-03-21 | 
| Last Update Date | 2023-10-22 |