| NPI | 1790782605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: PA MD433904) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD433904) |
| 2080P0207X Pediatrics, Pediatric Hematology-Oncology (Licence: MA 220358) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2008-10-03 |