| NPI | 1801005855 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301503602) | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 61019-20) | 
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: IA 36649) | |
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2023-06-27 |