| NPI | 1326304684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA 20A13831) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 111111111) |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2021-11-29 |