| NPI | 1578094868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA MD61050756) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10970494-1205) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-05-24 |