| NPI | 1255534855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: CT 62157) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.091439) |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2019-01-07 |