| 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 |