| NPI | 1033140777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 58500) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D55352) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-01-27 |