| NPI | 1861475865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G52223) |
| Additional Taxonomies | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: CA G52223) |
| Enumeration Date | 2005-11-22 |
| Last Update Date | 2019-07-23 |