| NPI | 1609958248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NJ 25MA055880) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA055880) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-04-11 |