| NPI | 1659862928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 12236681-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AZ R76848) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2021-05-29 |