NPI | 1184062275 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 83742) |
Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AL 35200) |
Enumeration Date | 2013-06-11 |
Last Update Date | 2021-02-17 |