| NPI | 1568802635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301102958) |
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: SC MMD.39169 TL) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2016-06-28 |