| NPI | 1174501985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NV 5408) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NV 5408) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2023-03-07 |