| NPI | 1326617499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 287501) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: ZZ 109812) |
| 208000000X Pediatrics (Licence: MA 287501) | |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2022-06-21 |