| NPI | 1568548543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: AZ 40926) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.085864) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2008-10-15 |