| NPI | 1871970731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 63085) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 68760-20) |
| 208000000X Pediatrics (Licence: TN 63085) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2021-07-09 |