| NPI | 1669554085 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MO 2009026148) | 
| Additional Taxonomies | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: KS 04-35466) | 
| Enumeration Date | 2006-10-19 | 
| Last Update Date | 2014-08-05 |