| NPI | 1639597305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: CA A173653) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CO DR.0058772) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2021-10-18 |