| NPI | 1306064654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AZ 63758) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 52752-20) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-10-12 |