| NPI | 1457763096 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: FL ME131091) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME131091) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2021-08-27 |