| NPI | 1063674620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A112409) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A112409) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-02-06 |