| NPI | 1548253412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: TN MD10675) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TN MD10675) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2010-11-03 |