| NPI | 1316209059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 52602) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125060894) |
| 208000000X Pediatrics (Licence: TN MD0000052602) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2022-06-29 |