| NPI | 1700204773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 65613) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 65613) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2023-01-02 |