| NPI | 1720058092 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: IA MD-45793)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: IA MD-45793)  | 
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301079456)  | |
| Enumeration Date | 2006-01-26 | 
| Last Update Date | 2018-12-10 |