| NPI | 1134501745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: IA MD-48780) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-48780) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 68940-20) | |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-11-04 |