| NPI | 1508891110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: MO 2009028894) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 28946) |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: KS 04-35438) | |
| 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: SC 28946) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2015-09-22 |