| NPI | 1386986909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 11767382-1204) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OR DO176689) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2021-12-20 |