| NPI | 1700999265 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX J4253) | 
| Additional Taxonomies | 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: TX J4253) | 
| 208000000X Pediatrics (Licence: TX J4253) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 23877) | |
| Enumeration Date | 2006-08-17 | 
| Last Update Date | 2022-01-25 |