| NPI | 1629341243 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2011013360) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MO 2011013360) |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2014-06-23 |