NPI | 1285913103 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA C201623) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CA C201623) |
2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MD D0091691) | |
Enumeration Date | 2011-08-09 |
Last Update Date | 2025-07-07 |