| NPI | 1861846719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NY 315732) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: NY 315732) | 
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.135759) | |
| Enumeration Date | 2016-04-18 | 
| Last Update Date | 2023-07-17 |