| NPI | 1518348523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 64145) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2015018539) |
| 2080H0002X Pediatrics, Hospice and Palliative Medicine (Licence: CA A154448) | |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A154448) | |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2022-06-19 |