| NPI | 1811382369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 57488) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA ML 60561469) |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2018-07-09 |