| NPI | 1104832377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207ZP0105X Pathology, Clinical Pathology/Laboratory Medicine (Licence: PA MD418146) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD418146) |
| 208000000X Pediatrics (Licence: PA MD418146) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |