| NPI | 1962602607 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 1020072) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.097799) | 
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.097799) | |
| Enumeration Date | 2007-07-20 | 
| Last Update Date | 2024-06-06 |