| NPI | 1609097013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MD D72879) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 229159) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-11-13 |