| NPI | 1265463046 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 243889) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 231213) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2015-08-20 |