| NPI | 1306063128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: NC 2007-00310) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NC 2007-00310) |
| 208000000X Pediatrics (Licence: NC 2007-00310) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2024-07-15 |