| NPI | 1588942353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PA md011021E) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD011021E) |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2011-07-28 |