| NPI | 1245572460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: MI 4301110072) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301110072) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2019-07-25 |