| NPI | 1689906356 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 11610939-1205) | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 63697) | 
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.098420) | |
| Enumeration Date | 2010-02-05 | 
| Last Update Date | 2021-12-17 |