| NPI | 1053497990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: DE C10008378) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 214133) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: FL ME124807) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-07-28 |