| NPI | 1205951639 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: WI 64618) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CO 47151) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: VA 0101252545) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2015-09-30 |