| NPI | 1811959687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TX L8128) |
| Additional Taxonomies | 207RH0003X Internal Medicine Hematology & Oncology (Licence: TX L8128) |
| 208000000X Pediatrics (Licence: TX L8128) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2023-04-20 |