| NPI | 1336113752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G068539) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME121139) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2024-08-20 |