| NPI | 1912170853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2008007445) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2008007445) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2021-11-15 |