| NPI | 1720423700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WV 29585) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN 56420) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-12-14 |