| NPI | 1104997956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G54677) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CA G54677) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2007-07-08 |