| NPI | 1447506365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 52076) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A121148) |
| 208000000X Pediatrics (Licence: TN 52076) | |
| Enumeration Date | 2012-07-29 |
| Last Update Date | 2018-09-21 |