| NPI | 1184853814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35.099808) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MT194915) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2014-08-05 |