| NPI | 1215930417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: GA 39043) |
| Additional Taxonomies | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TN 32030) |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: NC 2008-01313) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2021-01-06 |