| NPI | 1114913985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: IA 34448) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: ND PT11814) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2011-05-17 |