| NPI | 1770593303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MI 4301080862) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301080862) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-11-01 |