| NPI | 1376603407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301066305) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301066305) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2023-01-24 |