| NPI | 1548502313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: LA 321048) |
| Additional Taxonomies | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: KY 48709) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2019-10-28 |