| NPI | 1205943701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: GA 061411)  | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AL DO-646)  | 
| Enumeration Date | 2006-08-23 | 
| Last Update Date | 2013-12-12 |