| NPI | 1124175146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: SC 24783) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 055084) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2021-07-19 |