| NPI | 1093058851 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NJ 25MA05675500) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NY 165111-1) |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2013-03-30 |