NPI | 1518348523 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 64145) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015018539) |
2080H0002X (Licence: CA A154448) | |
2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A154448) | |
Enumeration Date | 2015-06-16 |
Last Update Date | 2022-06-19 |