| NPI | 1588151468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OK 7250) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 678380) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2021-06-11 |