| NPI | 1255918785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: WI 8146221) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 302861) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2024-04-05 |