NPI | 1972066587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WA OP61689646) |
Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 12751743-1204) |
Enumeration Date | 2019-04-10 |
Last Update Date | 2025-08-19 |