| NPI | 1043464373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA MD60536251) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR LL17969) |
| Enumeration Date | 2008-11-13 |
| Last Update Date | 2021-05-25 |