| NPI | 1457447807 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 48892) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 48892) | 
| Enumeration Date | 2006-10-05 | 
| Last Update Date | 2020-08-13 |