| NPI | 1881960029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 61823) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35139588) |
| 2080P0204X Pediatrics, Pediatric Emergency Medicine (Licence: ND 35139588) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2020-07-15 |