| NPI | 1598763112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: UT 6150957-1205) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: UT 6150957-1205) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2013-01-31 |