| NPI | 1689093379 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL OS17019) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 34.012742) |
| 208000000X Pediatrics (Licence: FL OS17019) | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2020-08-10 |