| NPI | 1548269285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080H0002X (Licence: HI DOS951) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: HI DOS951) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: HI DOS951) | |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2020-05-02 |