| NPI | 1669682837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: ND PT16066) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SD 9226) |
| 208000000X Pediatrics (Licence: WI 54187) | |
| 208000000X Pediatrics (Licence: PA MD436889) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: SD 9226) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-10-30 |