| NPI | 1003842162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MN 25330) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 25330) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2012-10-24 |