| NPI | 1508068776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: NC 2011-00102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-00102) |
| 208000000X Pediatrics (Licence: NC 2011-00102) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-07-03 |