| NPI | 1992857189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME115288) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD P21416) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2013-09-04 |