NPI | 1063863942 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A142147) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA 142147) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2020-11-05 |