| NPI | 1639361314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 7034509-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 7034509-1205) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2021-11-18 |