| NPI | 1568680023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A103406) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: RI LP00201) |
| 208000000X Pediatrics (Licence: CA A103406) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-04-16 |