| NPI | 1215183256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 238609) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 246128) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2009-06-24 |