| NPI | 1548354723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: VA 0101273594) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0101273594) |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: DC MD31602) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2022-03-31 |