| NPI | 1457791022 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 54483) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2013018924) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2023-03-17 |