| NPI | 1881641108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NY 252506-1) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: RI 03637) |
| 208000000X Pediatrics (Licence: NY 252506) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2015-01-05 |