| NPI | 1457619694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TX R6463) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA R 9349) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2023-04-11 |