| NPI | 1306224704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OR MD187076) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP03444) |
| 208000000X Pediatrics (Licence: OR MD187076) | |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2021-07-06 |