| NPI | 1992859573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 69708) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N8365) |
| 208000000X Pediatrics (Licence: WA MD00046603) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 208000000X Pediatrics (Licence: TN 69708) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2023-10-17 |