| NPI | 1750502092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA MD.MD.60376707) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N1321) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX N1321) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2016-06-16 |