| NPI | 1740452796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX Q4237) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 096763) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2024-02-28 |