| NPI | 1700058526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA C141227) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA C141227) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2019-08-23 |