| NPI | 1730455239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: CA C194438) |
| Additional Taxonomies | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: MA 262909) |
| 208000000X Pediatrics (Licence: CA C194438) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2024-03-06 |