| NPI | 1922027200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TN 47666) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 44209) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-05-09 |