| NPI | 1174865042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: PA MD485527) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: DC MD046980) |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: DC MD046980) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2024-06-24 |