| NPI | 1174943831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 69001) |
| Additional Taxonomies | 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: WI 69001) |
| Enumeration Date | 2014-04-21 |
| Last Update Date | 2023-01-09 |