| NPI | 1194713008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WV 23065) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD057257L) |
| 208000000X Pediatrics (Licence: WV 23065) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD057257L) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2022-04-13 |