| NPI | 1376993899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 64703) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301109421) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2022-03-07 |