NPI | 1700058526 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA C141227) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA C141227) |
Enumeration Date | 2008-04-01 |
Last Update Date | 2019-08-23 |