| NPI | 1366709271 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD455237)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD455237)  | 
| Enumeration Date | 2012-04-16 | 
| Last Update Date | 2019-05-17 |