| NPI | 1306820717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: OH 35-092263) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: KY 38797) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: KY 38797) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2010-05-26 |