| NPI | 1831216472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: SC 925) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: AL 1012) |
| 208000000X Pediatrics (Licence: SC LL 925) | |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2018-03-27 |