| NPI | 1124013826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: AL 29486) |
| Additional Taxonomies | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: IA 28926) |
| 208000000X Pediatrics (Licence: AL 29486) | |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2011-01-26 |