| NPI | 1982876082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A134720) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA A134720) |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2023-01-18 |