| NPI | 1194740688 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: TX M4653) | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX M4653) | 
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2012-04-24 |