| NPI | 1518232776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 10792178-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VT 060.0004039) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 59220) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: KS 04-40998) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2023-07-17 |