| NPI | 1790070126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 078230) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC LL33761) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2021-01-15 |