| NPI | 1073763140 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TX N0711) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX N0711) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2012-12-12 |