| NPI | 1174526735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.121922) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.121922) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2015-02-02 |