| NPI | 1174712962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A 108632) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A 108632) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2020-11-20 |