| NPI | 1710208251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: KS 05-39004) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2012010366) |
| Enumeration Date | 2010-06-18 |
| Last Update Date | 2022-01-25 |