| NPI | 1750381612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 40851) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 40851) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2019-03-18 |