| NPI | 1174941991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A154321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A154321) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A154321) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2023-08-06 |