| NPI | 1568492981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics Pediatric Hematology-Oncology (Licence: PA MD072735L) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD072735L) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2017-01-13 |