| NPI | 1538428065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2017012673) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 60260-20) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-07-21 |