| NPI | 1578757571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX R1915) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 45808) |
| 208000000X Pediatrics (Licence: LA 205885) | |
| 208000000X Pediatrics (Licence: TX R1915) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX 45808) | |
| Enumeration Date | 2007-09-01 |
| Last Update Date | 2017-06-27 |