| NPI | 1548796253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 64208) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 64208) |
| 208000000X Pediatrics (Licence: MN 28677) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2024-07-25 |