NPI | 1699181495 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 59626) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 59626) |
Enumeration Date | 2014-07-01 |
Last Update Date | 2022-04-29 |