| NPI | 1568624351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 079803) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: VA 0101258119) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 79803) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-08-07 |