| NPI | 1033297239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: DC MD30404) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NJ 25MA11639800) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-11-15 |