| NPI | 1164658217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX Q5354) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC TL31684) |
| 208000000X Pediatrics (Licence: AZ 46143) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2015-08-14 |