| NPI | 1881861235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 55987) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 55987) |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2015-08-18 |