NPI | 1780033852 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NE 30220) |
Additional Taxonomies | 208D00000X General Practice (Licence: NE 30220) |
Enumeration Date | 2016-06-08 |
Last Update Date | 2023-08-08 |