| NPI | 1891112108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AZ 61621) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 57.000000) |
| 208D00000X General Practice (Licence: AZ 61621) | |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2024-09-10 |