| NPI | 1366480485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301071038) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301071038) |
| 208000000X Pediatrics (Licence: MI 4301071038) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2014-01-23 |