| NPI | 1225443609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301112586) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2014018369) |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: MI 4301112586) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2020-06-15 |