| NPI | 1003965013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 200605) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: NC 200605) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2013-09-03 |